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end-of-life conversations: News and Media

CAFP will keep you posted on legal and legislative changes, new educational offerings, additional tools or resources and feedback from family physicians like you. If you have news items or stories to share, please send them to CAFP.

october 16, 2017

Dying in America has changed, but our comfort level in discussing it has not -- we still find it hard to do so. But we need to discuss death with our patients. Ask yourself, what do you want in those final months, weeks, days or hours? Then give your patients the same respect and consideration you would want yourself. Find out what they want.

November 1, 2016

The entire Visualizing Health Policy infographic provides a snapshot of Medicare and end-of-life care. Of 2.6 million total deaths in the United States in 2014, 2.1 million were among Medicare beneficiaries. Although Medicare spent significantly more on care for people at the end of life who died in 2014 ($34 529 per person) than for other beneficiaries that year ($9121 per person), the share of total Medicare spending for people at the end of life decreased from 18.6% to 13.5% between 2000 and 2014. Medicare spending for people at the end of life also decreased with age. Hospice use among Medicare beneficiaries at the end of life increased between 2000 and 2014 to nearly half (46%) of all beneficiaries. Medicare spending on hospice also increased during that period, from $2.3 billion to $10.4 billion. Surveys show that more than 7 in 10 people aged 65 years and older have not discussed end-of-life care with a physician and that 4 in 10 have not documented their end-of-life care wishes. Before January 1, 2016, Medicare did not reimburse physicians for patient visits to discuss end-of-life care, and as of 2016, 68% of physicians report that they have not received training for such discussions.

October 17, 2016

A study showed 69 percent of end-of-life forms filled out by elderly patients had at least one section that had been left blank, researchers reported in the Journal of the American Medical Directors Association. Researchers said 14 percent of the forms showed patients wanted to receive only comfort measures, but also showed they wanted to be taken to the hospital and given intravenous fluids or antibiotics, which could lead to unwanted care. "[I]t is important that signing physicians review the patient's wishes with the patient (or surrogate), to ensure that any inconsistencies or incomplete information are addressed when possible," the study authors said.

September 7, 2016

Over the last 15 years, as a geriatrics and palliative care doctor, I have had candid conversations with countless patients near the end of their lives. The most common emotion they express is regret: regret that they never took the time to mend broken friendships and relationships; regret that they never told their friends and family how much they care; regret that they are going to be remembered by their children as hypercritical mothers or exacting, authoritarian fathers.

And that’s why I came up with a project to encourage people to write a last letter to their loved ones. It can be done when someone is ill, but it’s really worth doing when one is still healthy, before it’s too late.

August 13, 2016

A young woman with ALS was ;able to pass peacefully, surrounded by her dear family and friends, with control and comfortability. Her sister shares the impact of being able to see her spend her last days exactly how she wanted to, under the freedom granted to her by the End of Life Option Act. "My sister is an example of exactly what the law intended to do: allow a dying young woman the ability to assert control over the chaos and uncertainty of terminal illness."

June 15, 2016

Amidst a sea of different cultural and religious beliefs about dying and cultural differences in communication, one of the simplest ways to respect a patient and their family is by asking questions, said Jay W. Lee, a past president of the California Academy of Family Physicians, which has not taken a position on the aid-in-dying law. Lee is currently an associate medical director at MemorialCare Medical Group in Long Beach.

June 6, 2016

Dr. Lee speaks about California's End of Life Option Act, and CAFP's work to assist family physicians' understanding of the law. "For most of us this may be a once or twice in a lifetime, or in a career, situation."

April 15, 2016;

Doctors know it's important to talk with their patients about end-of-life care. But they're finding it tough to start those conversations. When they do, they're not sure what to say, according to a national poll released.

March 4, 2016

Jay Lee, CAFP President was interviewed by Anna Forman, for a March 14 feature on Kaiser Health News. Dr. Lee said there is still a lot of uncertainty about the implications of California’s new law for physicians. But he said they will play an important role in helping ensure there is equitable access to the law across ethnic and socioeconomic groups in California — and that patients understand all their choices, including hospice and palliative care. Dr. Lee said he believes the law is already leading to more conversations about the end-of-life in general.

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